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How many mL of urine is used for Urinary Sediment Preparation
10-15 mL
Average mL of urine for Urinary Sediment Preparation
12 mL
For Urinary Sediment Preparation, urine should be centrifuged at how many RCF and for how long
400 RCF for 5 minutes
When decanting urine, how much is remained?
0.5-1.0 mL
A quantitative measure of formed elements of urine using hemocytometer
Addis count
Specimen used for Addis count
12-hour urine specimen
Preservative used for Addis count
Formalin
Normal values in Addis count
500,000/12-hour urine
Normal values of WBCs and epithelial cells in Addis count
1-1,800,000/12-hour urine
Normal value of Hyaline cast in Addis count
0-5,000/12-hour urine
This type of microscope is the most commonly performed in urinalysis laboratory; also used in routine urinalysis
Bright Field Microscopy
TRUE OR FALSE. When using Bright Field Microscopy, objects appear light against dark background.
FALSE
This type of microscopy enhances visualization of translucent elements and works by retardation of light rays diffused by the object involved
Phase Contrast Microscopy
What kind of effect does Phase Contrast Microscopy possess?
Halo effect
This type of microscope identified cholesterol in oval fat bodies, fatty casts and crystals.
Polarizing Microscopy
In polarizing microscopy, what pattern is produced in cholesterol?
Maltese cross
Dark Field Microscopy is useful for the identification of?
Treponema pallidum
This type of microscope is used for the visualization of fluorescent microorganisms or those stained by fluorescent dye
Fluorescence Microscopy
This type of microscopy is used for 3D microscopy image and layer by layer imaging of specimen
Interference Contrast Microscopy
What is the most frequently used stain in urinalysis?
Sternheimer-malbin (Crystal violet + Safranin O)
This delineates structure and contrasting colors of the nucleus and cytoplasm
Sternheimer-malbin
What does Sternheimer-malbin identifies?
WBCs, epithelial cells, casts
This enhances nuclear detail; supravital stain
Toluidine Blue
Toluidine blue differentiates what?
WBC and RTE cells
This lyses RBCs when added to urine sediments; enhances nuclei of WBCs (appears clear)
2% Acetic Acid
2% Acetic Acid distinguishes RBCs from?
WBCs, yeasts, oil droplets, crystals
This stains triglycerides and neutral fats
Lipid stains (Oil Red and Sudan III)
What is not stained in Lipid stains?
Cholesterol
What color is produced when Lipid stains is used?
Orange red
What does lipid stains identify?
Free fat droplets and lipid containing cells and casts
This differentiates gram positive and gram negative bacteria
Gram stain
Gram stain identifies what?
Bacterial cast
What stains eosinophilic granules?
Hansel stain (Eosin Y + Methylene blue)
Color of Eosin Y
Red
Hansel stain identifies what?
Urinary eosinophils
Increased urinary eosinophil may indicate what?
Interstitial nephritis
This stains structures containing iron
Prussian blue
What does Prussian blue identifies?
Hemosiderin granules in cells and casts
Normal value of RBCs in urinary sediments
0-2 or 0-3/HPF
In this type of urine, RBCs may crenate or shrink
Hypertonic urine
In this type of urine, RBCs may swell or hemolyze
Hypotonic urine
Dysmorphic with projections and fragmented RBCs can cause you to have what kind of damage?
Glomerular Membrane Damage
What are sources of error in the RBCs?
Yeast, Oil droplets, air bubble, calcium oxalate crystals
What is a way to distinguish RBC accurately?
Add 2% Acetic Acid
Increased numbers of WBCs in urinary sediments may indicate presence of what?
Urinary Tract Infection or Inflammation
Normal value of WBC in urinary sediments
0-1 or 0-2/HPF
Appearance of Neutrophils
Granulated and multi-lobed
Appearance of Eosinophils
Multi-lobed nucleus
Normal value of Eosinophils
1%
Eosinophils is associated with what kind of disease?
Drug-induced interstitial nephritis
These are lymphocytes, monocytes, macrophages, histiocytes that are seen in small amounts in urinary sediments
Mononuclear cells
This is the largest cell with abundant, irregular cytoplasm and prominent nucleus
Squamous Epithelial Cells
Squamous epithelial cells can be found from?
Linings of vagina, female urethra, lower portion of male urethra
Squamous epithelial cells has a variation which is known to be the abnormal type of squamous epithelial cells
Clue cells
Squamous epithelial cell covered with G. vaginalis is associated with?
Bacterial vaginosis
These are spherical, polyhedral or caudate with centrally located nucleus
Transitional Epithelial Cells
Transitional epithelial cells can be found from?
Lining of renal pelvis, ureter, urinary bladder, upper portion of male urethra
Increased numbers of Transitional epithelial cells are seen in?
Catheterization
Transitional Epithelial cells are commonly seen in patients with?
Chronic Kidney Disease and dialysis
This is the most clinically significant epithelial cell
Renal Tubular Epithelial Cells
The cytoplasm of RTE cells are?
Coarsely granular
Origin of RTE cells
Nephron
They are rectangular, polyhedral, cuboidal or columnar with an eccentric nucleus
Renal Tubular Epithelial Cells
2 RTE/HPF indicates?
Tubular injury
These are lipid containing RTE cells
Oval Fat Body
These are RTE cell with non-lipid filled vacuoles
Bubble cells
Bubble cell are seen in?
Acute Tubular Necrosis
Oval Fat body are usually seen in?
Lipiduria
Bacteria + WBC indicates?
Urinary Tract Infection
This is the most common cause of UTI
Enterobacteriaceae (Escherichia coli)
What does it mean when only bacteria is found in the urine sediment?
Old specimen, normal flora, contamination
Yeast + WBC indicates
True Yeast Infection
These are small, refractile oval structures that may or may not bud
Yeast
These are seen in vgainal moniliasis
Candida albicans
What does it mean when only yeast is found in the urine sediment?
Contamination, normal flora
Yeast are commonly seen in px with?
Diabetes mellitus
Parasites commonly seen in urinary sediments
Trichomonas vaginalis, Schistosoma haematobium ova, Enterobius vermicularis
These are usually seen after sexual intercourse
Spermatozoa
Major constituent of Mucus thread
Tamm-Horsfall protein
This is a prototype cast and is the beginning of all types of casts
Hyaline cast
Normal value of Hyaline cast
0-2/LPF
Hyaline cast may be physiologically due to?
Stress and strenuous exercise
Hyaline cast may be pathologically due to?
Glomerulonephritis, pyelonephritis, congestive heart failure
Presence of RBC casts may be due to?
Bleeding within the nephron, Glomerulonephritis, Strenuous exercise
Presence of WBC casts may be due to?
Inflammation within the nephron, Pyelonephritis, Acute Interstitial nephritis
WBC cast may be confused with?
Epithelial Cell cast
To differentiate WBC cast from epithelial cell cast
Phase microscopy and supravital stain
Only ______ stick to the cast because they are both in the kidney
Renal Tubular Epithelial Cells
Presence of RTE cell casts may be due to?
Advanced Tubular Destruction, Renal Tubular Damage
Bacterial casts can resemble?
Granular casts
Presence of Bacterial casts may be due to?
Pyelonephritis
Granules are derived from the _____ during normal metabolism
Lyososomes of the RTE cells
Presence of Granular casts casts may be due to?
Glomerulonephritis, pyelonephritis, stress, strenuous exercise
Fatty casts are not stained with?
Sternheimer-malbin stain
Final degenerative form of all types of cast. Brittle, highly refractive with jagged ends
Waxy cast
Stasis of urine flow of Waxy cast
Chronic Renal Failure
Broad cast is also known as?
Renal Failure Cast
This indicates destruction (widening of the tubular walls; extreme urine stasis, renal failure
Broad cast
These are acid, yellow brown, rosette and wedge shaped
Uric Acid
Acid, brick dust or yellow brown
Amorphous urates